The rationale for constructing and maintaining hospital corridors at 8 feet wide has shifted from a life safety issue to one of operations and logistics. The International Code Council (ICC) Ad Hoc Committee on Healthcare is considering recommending a change that would reflect this shift, codify more realistic requirements, and end confusion surrounding this issue, which has nagged hospitals for years and is reported to be among the top causes for Joint Commission citations. The recommended language would bring the I-Codes into line with a change in the 2012 edition of NFPA 101: Life Safety Code ® regarding corridor width.

The I-Codes currently require hospitals to provide corridors with 8 feet of clear and unobstructed width. An important proposal currently being debated by the ICC Ad Hoc Committee on Healthcare would clarify those corridor width requirements in the I-Codes, definitively identifying what equipment is permitted to be positioned in hospital corridors.

Most ICC ad hoc committee members recognize that the day-to-day operations of a hospital require keeping some equipment near patient rooms, including life-saving crash carts. While some code enforcement authorities allow such equipment to be staged in 8-foot corridors, others interpret the I-Codes to require 8 feet of completely clear corridor space at all times. The ad hoc committee’s work to clarify this issue could result in more consistent and realistic application of codes while keeping the means of egress safe and usable by staff and others during a disaster.

The advocacy team at the American Society for Healthcare Engineering (ASHE) of the American Hospital Association (AHA) points out that the need for quick access to critical equipment like crash carts far outweighs the probability of needing 8 feet of completely clear space during emergency evacuations, which are rare now that hospitals use quick response sprinkler systems and defend-in-place procedures. A look at the history of corridor width requirements further supports the argument that 8 feet allows plenty of space to position certain portable equipment in hallways without endangering hospital patients, visitors, staff, firefighters, and others who may be present during an emergency.

Decades ago, the Life Safety Code required hospitals to have corridors at least 4 feet wide. The rationale behind the requirement was that 4 feet would allow enough space for patients to be safely evacuated during a fire and give firefighters sufficient space to get into the facility. The 1961 edition of the Life Safety Code was the first to state that hospitals needed to have 8-foot corridors, said J. Armand Burgun, a past chairman of the NFPA’s Safety to Life Committee. The purpose of the change was to provide enough hallway space so that a patient confined to a bed could be safely wheeled to the exit in his or her bed, Burgun said.

Over the years, technological advancements outpaced the corridor width requirements. In 1988 the Life Safety Code Subcommittee on Healthcare Occupancies considered narrowing the corridor width requirement or removing it outright for the 1991 edition of the Life Safety Code. Hospitals were making the switch to be fully outfitted with quick response sprinklers, so the goal was no longer to wheel hundreds of bed-ridden patients out of the building during a fire. Instead, most patients would stay in their rooms while the fire was quickly extinguished in its room of origin. The advancement of quick response sprinklers and the advent of defend-in-place concepts meant that the 8-foot corridor issue was no longer relevant for life safety issues. The subcommittee questioned why it should dictate the width of the corridor if it no longer helped improve life safety, said Douglas Erickson, FASHE, CHFM, HFDP, CHC, deputy executive director of ASHE.

“The subcommittee said, ‘We don’t have a dog in the hunt anymore—it’s no longer a fire safety issue, so we shouldn’t be dictating the width of the corridor,’” Erickson said.

But the health care industry didn’t want to eliminate the requirement outright. AHA and others argued at the time that hospitals needed 8-foot corridors to function properly on a day-to-day basis. Keeping the requirement in the code would bring added functionality to ensure hallways remained wide enough for needed equipment, said William Koffel, PE, FSFPE, president of Koffel Associates, Inc.

“We were concerned that people might see that [elimination of the requirement] and start designing facilities with corridors less than 8 feet in width, and that would present some operational problems in the facility,” Koffel said.

However, requiring 8 feet of completely clear corridor space can be impractical for hospitals concerned with patient safety. The 2012 edition of NFPA 101 recognized that fact, and listed specific items that can be staged in corridors under certain conditions—marking the first time that clarification was made in the body of the Life Safety Code. While the changes to NFPA 101 give existing hospitals more freedom to operate, new hospitals can avoid the issue by including alcoves and other storage areas off the corridor where carts can be stored near patient rooms, Erickson said.

NFPA 101 now allows certain equipment to be staged in 8-foot corridors as long as 5 feet of clear width remains and hospital employees have a plan for removing the equipment during an emergency. That rule works well because the wheel base of many portable carts and pieces of equipment is less than 3 feet, Erickson said, easily leaving 5 feet of clear corridor width.

In the unlikely event that patients would need to be wheeled out of their rooms, the requirement of 5 feet of clear space provides an adequate width to safely move patients. Hospitals that had to evacuate during a fire or other emergency would likely transport patients on narrow gurneys or stretchers that are less than 3 feet, said Chad Beebe, AIA, CHFM, CFPS, CBO, associate director of advocacy for ASHE. If a patient needed to be wheeled out on his or her bed, there would still be enough space to do so. Beebe conducted an experiment using a patient bed that was 40 inches wide, and found that it could be wheeled out of the patient room and have enough room to turn the corner into the corridor with only 5 feet of space.

While 5 feet is enough space for hospital staff to move patients through the corridor, health care operators have no intention of cluttering the remaining 3 feet with fax machines, file cabinets, and other basic storage needs, and that type of storage would not be permitted. The 2012 edition of the Life Safety Code outlines specific wheeled items that can be staged in corridors to ensure that hallways don’t become storage closets. Items allowed are:

Equipment and carts being used by hospital workers

Medical emergency equipment not in use, such as crash carts and isolation carts

Patient transportation devices, such as portable lifts and wheelchairs

The ICC ad hoc committee is considering proposing similar language for the I-Codes to spell out exactly what is allowed in hospital corridors. The committee is scheduled to meet next in early October and will submit proposals to change the I-Codes by January 2012. An ICC committee vote is scheduled in Dallas from April 29 to May 6, 2012. The deadline for public comments is August 1, 2012, and a final action hearing is scheduled for October in Portland, Ore.

To get involved with the I-Codes revision process, contact ASHE or the ICC Ad Hoc Committee on Healthcare, attend one of the ad hoc committee meetings, or listen in on the numerous technical calls. Information about the committee’s meetings is available online at http://www.iccsafe.org/cs/AHC/Pages/default.aspx. For more information, contact Chad Beebe at cbeebe.aha@gmail.com.